Shoulder prothesis with humeral fracture stem

ABSTRACT

A shoulder prosthesis including a fracture stem has a body having an exterior surface, a shank attached to the body and a head. The body includes a medial fin, an anterior fin and a posterior fin. The medial fin includes a suture hole. The anterior and posterior fins each include a plurality of suture holes. The prosthesis further includes a lateral suture hole intersecting the exterior surface of the body. The lateral suture hole may be formed in a projection on the lateral side of the prosthesis. In an alternative embodiment, a trail prosthesis includes indicia for noting the proper placement of the stem. The prosthesis includes corresponding indicia for replicating the placement of the trial stem.

This application is a continuation-in-part of U.S. patent applicationSer. No. 09/394,557 filed on Sep. 10, 1999. This application claimsbenefit under 35 U.S.C. §119(e) of U.S. Provisional P Application No.60/123,860 filed on Mar. 3, 1999 and U.S. Provisional Patent ApplicationNo. 60/117,984 filed on Mar. 12, 1999.

BACKGROUND AND SUMMARY OF THE INVENTION

The present invention relates to a prosthesis, and, in particular, to ashoulder prosthesis including a humeral stem. The present invention alsorelates to a method for determining a desirable humeral stem height.

Various artificial shoulder prostheses with humeral stems are known. Twoexamples of such prosthesis are shown in U.S. Pat. Nos. 5,728,161 and5,314,479. The prosthesis of the '161 patent generally includes a shankportion, a head portion and an attachment mechanism for securing thehead portion to the shank portion. Some prosthetic shoulders, such asthat shown in FIG. 1 of the '161 patent, include one or more fins formedon the body portion of the device. The fins may include suture holes. Inother prosthetic shoulders, some or all of the fins do not includesuture holes. Such a device is shown in FIG. 1 of the '479 patent.Additional shoulder prosthesis are shown and discussed in U.S. Pat. No.5,032,132 to Matsen et al.; U.S. Pat. No. 4,865,605 to Dines et al.;U.S. Pat. No. 4,919,670 to Dale et al.; U.S. Pat. No. 5,358,526 toTomier; U.S. Pat. No. 5,507,817 to Craig et al.; U.S. Pat. No. 4,045,825to Stroot; and U.S. Pat. No. 4,042,980 to Swanson et al.

Shoulder prostheses are sometimes used to repair what is known as a“four part humeral fracture.” Such a fracture typically occurs in theproximal region of the humerus. Often, the humeral head, greatertubercle and lesser tubercle separate from the humeral shaft, thusleaving four parts. A shoulder prosthesis may be used to replace thehumeral head and provide a point of attachment for the greater andlesser tubercles.

One embodiment of the present invention provides a shoulder prosthesisincluding a body having an exterior surface, a shank connected to thebody, a head connected to the body, a medial fin connected to the body,the medial fin including at least one suture hole, a posterior finconnected to the body, the posterior fin including at least one suturehole, an anterior fin connected to the body, the anterior fin includingat least one suture hole and at least one lateral suture holeintersecting the exterior surface of the body. The suture hole may beformed in a projection on the exterior surface of the body. At least oneof the anterior and posterior fins may extend farther above the exteriorsurface of the body than the projection. At least one of the anteriorand posterior fins may extend at least twice as far above the exteriorsurface of the body as the projection. A plurality of the suture holesin the anterior and posterior fins and the lateral suture hole may liein the same plane.

According to another embodiment of the present invention, a shoulderprosthesis includes a body having an exterior surface, a shank connectedto the body, a first suture hole located on the lateral side of theprosthesis and an anterior fin connected to the exterior surface of thebody, the anterior fin having a second suture hole the center of whichis spaced farther from the exterior surface of the body than the centerof the first suture hole. The first suture hole may intersect theexterior surface of the body and may be formed in a projection on theexterior surface of the body. In one embodiment, the anterior finextends farther above the exterior surface of the body than theprojection. The anterior fin may extend at least twice as far above theexterior surface of the body as the projection. The shoulder prosthesismay include a posterior fin having a third suture hole the center ofwhich is spaced farther from the exterior surface of the body than thecenter of the first suture hole. The first, second and third sutureholes may lie in the same plane.

According to another embodiment of the present invention, a shoulderprosthesis includes a body having an exterior surface, a shank portionattached to the body, the shank portion configured to be received withinthe medullary canal of a human humerus, an anterior fin including atleast one suture hole, the anterior fin and at least one suture holeproviding an attachment point for the greater and lesser tubercles and aleast one lateral suture hole intersecting the exterior surface of thebody, the at least one lateral suture hole providing an attachment pointfor the greater tubercle to prevent rotation of the greater tubercle. Atleast one lateral suture hole may be formed in a projection on theexterior surface of the body. The anterior fin may extend farther abovethe exterior surface of the body than the projection and may extend atleast twice as far above the exterior surface of the body as theprojection. The prosthesis may also include a posterior fin including atleast one suture hole, the posterior fin and at least one suture holeproviding an attachment point for the greater and lesser tubercles. Inone embodiment, at least one lateral suture hole lies in the same planeas at least one of the suture holes in the anterior fin and at least oneof the suture holes in the posterior fin.

According to an additional embodiment, a trial stem is provided withmeasurement indicia thereon and a shoulder prosthesis is provided withcorresponding indicia thereon.

Also according to the present invention, a method is provided forpositioning a shoulder prosthesis so as to allow for ample space foranatomic reconstruction of the tuberosities and anatomic reconstructionof the humeral articular surface. The method includes using a trialprosthesis, noting the position an indicia on the trial and uponimplantation of the actual prosthesis, positioning a correspondingindicia in the same location.

Other features of the present invention will be apparent to those ofordinary skill in the art from the following detailed description of thepreferred embodiments and accompanying drawings.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a view of a four part proximal humeral fracture.

FIG. 2 is an exploded side elevational view of one embodiment of ashoulder prosthesis according to the present invention.

FIG. 3 is a lateral elevational view of the shoulder prosthesis shown inFIG. 2.

FIG. 4 is a plan view of the collar of the shoulder prosthesis shown inFIG. 2.

FIG. 5 is a side elevational view of the shoulder prosthesis shown inFIG. 2 implanted in a patient's arm.

FIG. 6 is a side elevational view of a trial stem having indiciastarting at an inferior aspect of anterior and posterior fins andextending spaced-apart from one another, alternating with short and longlines.

FIG. 7 is a side elevational view of a shoulder prosthesis according toanother embodiment of the present invention including indicia spacedapart from one another to mark the appropriate position of theprosthesis in relation to the humeral shaft, and an anterior fin.

FIGS. 8-10 are views of the prosthesis of FIG. 7 being positioned invarious locations.

FIG. 11 is a view of the prosthesis of FIG. 7 positioned to preservespace for anatomic reconstruction of the tuberosities.

DETAILED DESCRIPTION OF THE DRAWINGS

FIG. 1 illustrates a typical four part humeral fracture. In such afracture, the humeral head breaks free and does not have any soft tissueattachment or blood supply. The greater tuberosity is displacedsuperiorly and posteriorly by the pull of the attached rotator cuffwhile the lesser tuberosity is retracted medially by the pull of thesubscapularis. The neck of the humeral shaft is displaced medially bythe pull of the pectoralis major. Other variations of the four parthumeral fracture are also possible. The shoulder prostheses of thepresent invention are useful for repairing the fracture shown in FIG. 1,including other variations, and for correcting other deformities andinjuries to the shoulder joint and humerus.

FIG. 2 is a side elevational view of a shoulder prosthesis 10 accordingto one embodiment of the present invention. Prosthesis 10 generallyincludes a stem portion 20 and a head portion 30. Stem portion 20generally includes a body portion 40 and a shank portion 50.

Body portion 40 includes an exterior surface 41 having a first or medialfin 42, a second fin 43, and a third fin 44 connected thereto. Note thatdepending on the arm into which prosthesis 10 is inserted, fins 43 and44 are either the anterior or posterior fin. For example, if the view ofFIG. 2 is considered a posterior view, the prosthesis would be in thepatient's left arm and fin 43 would be a posterior fin, while fin 44would be an anterior fin. Conversely, if the view shown in FIG. 2 isconsidered an anterior view, the prosthesis would be located in thepatient's right arm, thereby making fin 43 the anterior fin and fin 44the posterior fin.

Fin 42 includes a suture hole 42 a which partially intersects exteriorsurface 41 of body portion 40. Fin 43 includes a first or proximalsuture hole 43 a, a second or middle suture hole 43 b, and a third ordistal suture hole 43 c. Similarly, fin 44 has a first or proximalsuture hole 44 a, a second or middle suture hole 44 b, and a third ordistal suture hole 44 c. Body portion 40 further includes a lateralprojection 45. Note that in the embodiment shown, fins 43 and 44 bothextend farther above exterior surface 41 than does projection 45. Infact, in the embodiment shown, fins 43 and 44 both extend at least twiceas far above exterior surface 41 than does projection 45.

A lateral suture hole 45 a is formed partially within lateral projection45 and partially within body portion 40. That is, suture hole 45 aintersects or cuts into exterior surface 41 of body portion 40. This isin contrast to the suture holes in fins 43 and 44, which do not, in theembodiment shown, intersect exterior surface 41 of body portion 40.Rather, they are entirely located within fins 43 and 44. Additionally,in the embodiment shown, the center of each of suture holes 43 a, 43 b,43 c, 44 a, 44 b and 44 c are all spaced farther from exterior surface41 of body 40 than the center of suture hole 45 a.

In the embodiment shown, suture holes 43 a, 45 a and 44 c are located ina common plane indicated by the letter “A” in FIG. 3. Similarly, in theembodiment shown, suture holes 44 a, 45 a and 43 c lie in a common planeindicated by the letter “B” in FIG. 4. Likewise, suture holes 43 b, 45 aand 44 b lie in a common plane indicated by the letter “C” in FIG. 4.

Body portion 40, in the embodiment shown, further includes a collar 46.Collar 46 includes a first or proximal surface 47 and a second or distalsurface 48. An opening 47 a extends through collar 46 and into bodyportion 40. Opening 47 a is used to secure head 30 to stem portion 20 asdescribed below. In the embodiment shown, collar 46 is generallycircular and integrally formed with body portion 40. However, collar 46could be formed as a separate piece and attached to body 40 in any of anumber of ways. One such way is shown in U.S. Pat. No. 5,314,479, thedisclosure of which is hereby incorporated by reference.

Shank portion 50 includes a first or proximal end 51 adjacent bodyportion 40 and a second or distal end 52. Shank portion 50 may be formedas a unitary piece with body portion 40. Alternatively, shank portion 50may be formed in one or more pieces and attached to body portion 40 inany one of a number of known manners. One example of such a means orapparatus for attaching a shank portion to a body portion of a shoulderprosthesis is shown in U.S. Pat. No. 5,314,479, the disclosure of whichis incorporated herein by reference. Shank portion 50 tapers such thatit is narrower near distal end 52 and wider at proximal end 51. Thistaper of the stem helps to properly load the cement mantle when theprosthesis is inserted, thereby properly transferring forces from theimplant to the humeral shaft. In the embodiment shown, the stem portion50 also includes a plurality of flutes 53. Flutes 53 improve theadhesion of the bone cement to the shank. Flutes 53 also improve therotational stability of the device when implanted.

Head 30 is designed to replace the humeral head and articulate withinthe glenoid cavity as is well known in the art. Head 30 generallyincludes a first or articulating surface 31, a second interior surface32, a third or distal surface 33, and an attachment post or projection34. Projection 34 and the interior of head 30 are configured such thatprojection 34 will be received within opening 47 a and collar 46 will belocated on the interior of head 30 such that surface 33 contacts bodyportion 40 on the lateral side of the prosthesis. Projection 34 andopening 47 a are, in the embodiment shown, configured in the form of ataper lock or Morse taper, as is known in the art. Alternative methodsof attaching head 30 to body potion 40 could also be used, such as thosedisclosed in U.S. Pat. No. 5,314,479.

FIG. 5 shows a cross-sectional view of the prosthesis of FIG. 2implanted in a human humerus. To implant the prosthesis of the presentinvention in, for example, a humerus that has suffered a four parthumeral fracture, the intramedullary canal is reamed to the appropriatesize and configuration for the device to be implanted. Bone cement isthen introduced into the prepared cavity, as is known in the art, anddistal end 52 is inserted into the cavity. Shank 50 is pushed furtherinto the cavity until the desired insertion depth is reached.

As noted above, a plurality of suture holes 42 a, 43 a, 43 b, 43 c, 44a, 44 b, 44 c and 45 a are provided on body portion 40. Suture holes 43a, 43 b and 43 c in fin 43 and 44 a, 44 b and 44 c in fin 44 may beutilized to reattach the lesser tubercle. The fin to which the lessertubercle is attached will depend on the arm into which the prosthesis isimplanted. To reattach the lesser tubercle, a groove corresponding tothe shape of fin 43 or 44 is formed in the lesser tubercle and one ormore sutures are tied to the lesser tubercle through one or more ofsuture holes 43 a, 43 b and 43 c or 44 a, 44 b and 44 c, depending onwhether the lesser tubercle is attached to fin 43 or 44.

In the typical four part humeral fracture, it is also necessary toreattach the greater tubercle. It has been found in many four-parthumeral fractures that better positioning of greater tubercle can beobtained if it is attached to the anterior and/or posterior fins.However, in some prior art devices, the body portion includes aprojecting lateral fin with one or more suture holes. In such devices,the suture holes are sometimes placed too far from the surface of thebody for proper attachment of the greater tubercle. Thus, the device mayprovide an anatomically improper attachment location for the greatertubercle. Note also that in such devices it would be necessary to cut agroove in the surface of the greater tubercle to provide space for thelateral fin.

Some prior art devices do not include any lateral suture holes. Thus,the greater tubercle cannot be improperly attached at a laterallocation. However, it has also been found that in some instances it maybe desirable to provide a point of lateral attachment for the greatertubercle to prevent anterior rotation of the greater tubercle from thepull ofthe attached muscles. The present invention provides a singlelateral suture hole 45 a for this purpose. Note that the lateral suturehole is positioned closely adjacent the body portion 40 and, in theembodiment shown, actually intersects outer surface 41 of body portion40. This provides a more anatomically correct attachment point for thegreater tubercle than a prosthesis in which the suture holes are spacedfurther from the body portion of the prosthesis. Note also that theelimination of the lateral fin in the embodiment shown means that it isnot necessary to cut a groove in the greater tubercle. Instead, it mayonly be necessary to make a small indentation to accommodate projection45.

Thus, in the present invention, the greater tubercle is attached toeither or both of fins 43 and 44 by sutures that extend through one ormore of suture holes 43 a, 43 b, 43 c, 44 a, 44 b and 44 c. Ifnecessary, the greater tubercle may also be secured by a sutureextending through suture hole 45 a.

When the prosthesis is fully inserted and the greater and lessertubercles are reattached, distal surface 48 of collar 46 will rest onthe tubercles. Note that this placement of collar 46 will help totransmit loads on the shoulder to the humeral bone. Head 30 is thenattached to body 40 by inserting projection 34 into opening 47 a andimpacting the head to engage the Morse taper.

FIGS. 6-11 show an alternative embodiment of the present invention. Whenimplanting a shoulder prosthesis, it is necessary to determine thedesirable rotational position and height of the stem portion in thehumerus. Accordingly, a trial stem and shoulder prosthesis includingindicia to allow a surgeon to transfer the already determined heightrequirements from the trial to the prosthesis are provided.

FIG. 6 illustrates a trial stem according to one embodiment of thepresent invention. Trial stem 100 generally includes the same parts andfeatures as stem portion 20 of shoulder prosthesis 10. Accordingly, inFIG. 6, elements of trial stem 100 corresponding to elements of stemportion 20 are indicated by the same number with the addition of thenumeral “1” at the beginning. Body portion 140 of trial stem 100includes a plurality of indicia 140 a. Indicia 140 a may be placed onone or both sides of body portion 140. Alternatively, indicia 140 a maybe placed at any location where they will be sufficiently visible so asto allow the surgeon to determine the proper placement of theprosthesis. Indicia 140 a may be placed on body portion 140 in any oneof a number of manners. For example, indicia 140 a may be etched orengraved on body portion 140. Alternatively, indicia 140 a may be markedon body portion 140 with an appropriate ink, paint or similar substance.Indicia 140 a could be coupled to body portion 140 using adhesive,fasteners or any other suitable means. Holes or similar features canalso be used as indicia 140 a. Indicia 140 a may be spaced apart in anydesired pre-determined units, such as inches or centimeters. Indicia 140a could also be color coded or marked in any other manner suitable toindicate to a user various measurements. Preferably, the indicia 140 aare lines spaced-apart about 5 mm. It is appreciated that this spacingcould be either more or less. Indicia 140 a may be marked with numbers.For example, the distal most line could be numeral 0, then numeral 5 forthe next line, etc. The height of stem portion 120 may also be gauged byan additional series of holes, dimples or other markings in or on fins143 and/or 144, or holes or dimples in body portion 140. FIGS. 7-11illustrate an alternative embodiment of a shoulder prosthesis accordingto the present invention. Shoulder prosthesis 200 generally includes thesame parts and features as shoulder prosthesis 10. Accordingly, in FIGS.7-11, elements of shoulder prosthesis 200 corresponding to elements ofshoulder prosthesis 10 are indicated by the same number with theaddition of the numeral “2” at the beginning. Body portion 240 of stemportion 220 includes indicia 240 a corresponding to indicia 140 a onbody portion 140 of stem portion 120. Indicia 240 a may be formed andpositioned in any of the manners discussed above with respect to indicia140 a.

In use, stem portion 120 of trial 100 is placed into the preparedintramedullary canal of the humerus and rotated and raised or lowereduntil there is sufficient space for the tuberosity reconstruction andsufficient joint range of motion. The joint range of motion can beevaluated by assembling a trial humeral head to stem portion 120 andpreforming a trial reduction, as is well known in the art. Once thedesired position of stem portion 120 is determined, it can be gauged ormeasured by noting the position of a given indicia 140 a. The surgeonthen removes stem portion 120. After removing stem portion 120, Thesurgeon inserts stem portion 220 of prosthesis 200 into the preparedintramedullary canal of the humerus until the indicia 240 acorresponding to the noted indicia 140 a is properly positioned. FIGS.8-11 illustrate positioning of prosthesis 200 in the humerus. Forexample, prosthesis 200 is shown in FIG. 9 as having been raised fromthe position shown in FIG. 8. According, additional indicia 240 a arevisible. FIGS. 10 and 11 illustrate this in another manner. FIG. 10shows the desired position of the humeral articular surface for head 230in dashed lines. FIG. 11 shows the prosthesis 200 raised such that head230 is in the proper position and being held in place by a surgicalinstrument 300.

Although the present invention has been shown and described in detail,the same is for purposes of illustration only and is not intended tolimit the scope of the invention. Numerous changes may be made to theembodiments discussed without departing from the scope and spirit of thepresent invention. For example, a plurality of stems, bodies, collarsand heads could be provided to produce a prosthetic kit in which thepieces can be interchanged to customize the prosthesis. Additionally,the various components can take shapes other than those specificallyillustrated in the embodiments discussed. Stem portion 50 could also beprovided with a porous coating or other bone ingrowth material toenhance fixation. Furthermore, use of the device is not limited to fourpart humeral fractures. Accordingly, the scope of the present inventionis to be limited only by the terms of the attached claims.

What is claimed is:
 1. A shoulder prosthesis, comprising: a body havingan exterior surface; a shank connected to the body; a head connected tothe body; a medial fin connected to the body, the medial fin includingat least one suture hole; a posterior fin connected to the body, theposterior fin including at least one suture hole; an anterior finconnected to the body, the anterior fin including at least one suturehole; and at least one lateral suture hole intersecting the exteriorsurface of the body.
 2. The shoulder prosthesis according to claim 1,wherein at least one lateral suture hole is formed in a projection onthe exterior surface of the body.
 3. The shoulder prosthesis accordingto claim 2, wherein at least one of the anterior and posterior finsextends farther above the exterior surface of the body than theprojection.
 4. The shoulder prosthesis according to claim 2, wherein atleast one of the anterior and posterior fins extends at least twice asfar above the exterior surface of the body as the projection.
 5. Theshoulder prosthesis according to claim 1, wherein at least one lateralsuture hole lies in the same plane as at least one of the suture holesin the anterior fin and at least one of the suture holes in theposterior fin.
 6. The shoulder prosthesis according to claim 1, whereinthe anterior and posterior fins each include a distal, middle andproximal suture hole and at least one lateral suture hole lies in thesame plane as the proximal suture hole in the anterior fin and thedistal suture hole in the posterior fin.
 7. The shoulder prosthesisaccording to claim 1, wherein the anterior and posterior fins eachinclude a distal, middle and proximal suture hole and at least onelateral suture hole lies in the same plane as the distal suture hole inthe anterior fin and the proximal suture hole in the posterior fin. 8.The shoulder prosthesis according to claim 1, wherein the anterior andposterior fins each include a distal, middle and proximal suture holeand at least one lateral suture hole lies in the same plane as both ofthe middle suture holes.
 9. The shoulder prosthesis according to claim1, wherein the anterior and posterior fins each include a distal, middleand proximal suture hole and one lateral suture hole lies in the sameplane as the proximal suture hole in the anterior fin and the distalsuture hole in the posterior fin, the distal suture hole in the anteriorfin and the proximal suture hole in the posterior fin and both middlesuture holes.
 10. A shoulder prosthesis, comprising: a body having anexterior surface; a shank connected to the body; a first suture holelocated on the lateral side of the prosthesis; and an anterior finconnected to the exterior surface of the body, the anterior fin having asecond suture hole the center of which is spaced farther from theexterior surface of the body than the center of the first suture hole.11. The shoulder prosthesis according to claim 10, wherein the firstsuture hole intersects the exterior surface of the body.
 12. Theshoulder prosthesis according to claim 10, wherein the first suture holeis formed in a projection on the exterior surface of the body.
 13. Theshoulder prosthesis according to claim 12, wherein the anterior finextends at least twice as far above the exterior surface of the body asthe projection.
 14. The shoulder prosthesis according to claim 12,wherein the anterior fin extends farther above the exterior surface ofthe body than the projection.
 15. The shoulder prosthesis according toclaim 10, further including a posterior fin having a third suture holethe center of which is spaced farther from the exterior surface of thebody than the center of the first suture hole.
 16. The shoulderprosthesis according to claim 15, wherein the first, second and thirdsuture holes lie in the same plane.
 17. A shoulder prosthesis,comprising: a body, the body having an exterior surface; a shank portionattached to the body, the shank portion configured to be received withinthe medullary canal of a human humerus; an anterior fin including atleast one suture hole, the anterior fin and at least one suture holeproviding an attachment point for the greater and lesser tubercles; anda least one lateral suture hole intersecting the exterior surface of thebody, the at least one lateral suture hole providing an attachment pointfor the greater tubercle to prevent rotation of the greater tubercle.18. The shoulder prosthesis according to claim 17, wherein at least onelateral suture hole is formed in a projection on the exterior surface ofthe body.
 19. The shoulder prosthesis according to claim 18, wherein theanterior fin extends farther above the exterior surface of the body thanthe projection.
 20. The shoulder prosthesis according to claim 18,wherein the anterior fin extends at least twice as far above theexterior surface of the body as the projection.
 21. The shoulderprosthesis according to claim 17, further including a posterior finincluding at least one suture hole, the posterior fin and at least onesuture hole providing an attachment point for the greater and lessertubercles.
 22. The shoulder prosthesis according to claim 21, wherein atleast one lateral suture hole lies in the same plane as at least one ofthe suture holes in the anterior fin and at least one of the sutureholes in the posterior fin.
 23. The shoulder prosthesis according toclaim 21, wherein the anterior and posterior fins each include a distal,middle and proximal suture hole and at least one lateral suture holelies in the same plane as the proximal suture hole in the anterior finand the distal suture hole in the posterior fin.
 24. The shoulderprosthesis according to claim 21, wherein the anterior and posteriorfins each include a distal, middle and proximal suture hole and at leastone lateral suture hole lies in the same plane as the distal suture holein the anterior fin and the proximal suture hole in the posterior fin.25. The shoulder prosthesis according to claim 21, wherein the anteriorand posterior fins each include a distal, middle and proximal suturehole and at least one lateral suture hole lies in the same plane as bothof the middle suture holes.
 26. The shoulder prosthesis according toclaim 21, wherein the anterior and posterior fins each include a distal,middle and proximal suture hole and one lateral suture hole lies in thesame plane as the proximal suture hole in the anterior fin and thedistal suture hole in the posterior fin, the distal suture hole in theanterior fin and the proximal suture hole in the posterior fin and bothmiddle suture holes.
 27. The shoulder prosthesis according to claim 1further including at least one indicia on the body for positioning theprosthesis.
 28. The shoulder prosthesis according to claim 10 furtherincluding at least one indicia on the body for positioning theprosthesis.
 29. The shoulder prosthesis according to claim 17 furtherincluding at least one indicia on the body for positioning theprosthesis.